TRC Final Report

Volume 4

Chapter 5

Subsection 19

Mental health organisations in South Africa

122 The South African Psychological Association (SAPA) was founded in 1948, with a membership of thirty-four. In 1962, following the admission of a black member, a new association, the Psychological Institute of the Republic of South Africa (PIRSA), was established exclusively for whites. The two organisations merged in 1983 to form the Psychological Association of South Africa (PASA). Black professionals were permitted as members but, because of the racist history of PIRSA, many chose to join the Black Psychologists' Association instead.

123 OASSSA was formed in 1985. It included psychologists and social service workers, and attempted to provide social services (largely counselling) to communities and individuals that did not generally have access to them.

124 Finally, in 1994, the Psychological Society of South Africa (PsySSA) was formed. This organisation represented the professional interests of South African psychologists and was attempting, at the time of reporting, to bring about transformation in the field of mental health care.

125 The Society of Psychiatrists of South Africa (SPSA) is a sub-group of the MASA and was formed in 1966. About half of the approximately 300 registered psychiatrists in South Africa are members. Commenting on its activities over the previous thirty years, the SPSA said:

That the SPSA had to be prodded into adopting a more distinct role, that of lobbying the government for equal and adequate facilities for all the country’s mentally ill, regardless of race, is evident … Much of the Society’s concern with respect to apartheid was generated in response to external pressures and reports since 1977.

126 In other words, the SPSA was a largely reactive body that did not play a proactive role in ensuring that the human rights of mentally ill people were upheld.

127 In addition to the professional organisations mentioned, a number of societies working in the area of mental health were formed over the years. In 1920, the South African National Council for Mental Hygiene and the Care of the Feebleminded was formed in an attempt to facilitate communication and formalise the relationship between the government and these societies. This Council was originally structured in such a way that at least half of the members of the policy making board were government psychiatrists. In addition, the Broederbond managed to influence policy significantly.

The Board of the SA National Council for Mental Health was, therefore, at least until the early 1980s, heavily influenced by two power groups not representative of civil society, namely government psychiatrists who sought to protect government mental health services from criticism and reform, and the Afrikaner Broederbond, which oversaw the implementation and maintenance of a Christian National Philosophy, which is today recognised as being a euphemism for apartheid.

In 1966, the Department of Social Welfare and Pensions issued its notorious Consolidated Circular no 29 [Appendix 4], according to which welfare organisations were no longer allowed to have racially mixed memberships … The National Council for Mental Health complied with the circular by excluding all black persons from its meetings and membership.

128 This was in direct contravention of the constitution of the World Federation for Mental Health (of which the National Council for Mental Health was a member), which affirmed non-discrimination on racial grounds as a major principle. The World Federation failed to act against its South African affiliate, however.

129 During the 1980s, the Council began a gradual process of transformation, starting with racial integration. Eventually, after wide consultation, the South African Federation for Mental Health (SAFMH) was formed in 1992.

130 Some would argue that, because the profession was so small, any intervention or declarations would have had little effect. In addition, the fact that psychology was low in the hierarchy of health care has been put forward as a reason for the profession’s failure to act on issues which should have drawn rigorous condemnation. These arguments, however, appear more as attempts at self-justification than as valid reasons for the profession’s failure to respond to human rights abuses. For instance, in July 1987, the SPSA issued the following statement:

The implementation of section 29 of the Internal Security Act 74 of 1982 and other Emergency Regulations involves a type of detention such as isolation, solitary confinement, immoderate interrogation, etc., that in our opinion may damage the mental health of many persons so detained.

We accept that it is our bounden duty to effectively treat and prevent relapse in the mentally disordered. We wish to express unequivocally our opposition to practices that lead to mental breakdown.

While we accept that justice must be done and that security must be maintained, we believe that this should not be achieved in a manner that diminishes the dignity of the individual or the integrity of his or her mind and body.

131 This mild (and somewhat euphemistic) statement could surely have been issued much earlier than mid-1987. Incontrovertible evidence of the mentally deleterious effects of detention, solitary confinement and torture existed decades before this. The SAFMH submission reflected on this:

The Board members and staff of the SAFMH acknowledge that the Board of the National Council for Mental Health was guilty of activities contrary to the promotion of good mental health, by actively and tacitly supporting the apartheid policies of the previous government and failing to support those within its ranks who protested against apartheid atrocities and human rights violations in the field of mental health. They are also conscious of many acts of omission during the apartheid era and that, instead of campaigning actively against the mental illness of apartheid, they remained silent … They express their sincere regret for the Federation’s action in this respect …They will in future strive towards the social welfare of all South Africa’s people, with special recognition of those who have been previously disadvantaged.